This disclosure relates to a device for reducing and repairing fractures of small bones and more particularly to a device for reducing fractures of the bones of the hands and feet, for clamping plates to those bones and for guiding a drill during drilling of the plate and bone to facilitate attachment of the plate to the bone.
Typically, fractures of the bones of the hands (e.g., the metacarpals) and feet (e.g., the phalanges) are reduced and then a plate is secured to the bone with bone screws passing through the bone and the plate on opposite sides of the fracture to hold the bone sections in place during healing. It is often difficult for surgeons to reduce a fracture while simultaneously positioning and affixing a plate to the fractured bone. Currently, surgeons must hold a plate on the bone with either a clamp or their hands while screw holes are drilled through the plate and into the bone. These screw holes must be drilled in the precise location and orientation the surgeon desires. Since the bones of the hands and feet are relatively small, there is little margin of error to correct for misplaced screw holes.
Most surgeons use medical pliers or other small clamping devices to perform the aforementioned functions. However, these instruments are not designed to simultaneously reduce a fracture and secure a plate in a desired location. As a result, it is often difficult to correctly position the pliers or clamping devices and still allow enough room to drill holes and place screws. Additionally, in order to accurately drill screw holes, a second device is required. Currently a hand held drill guide or a clamp containing a point contract drill guide is used to guide the drill while drilling holes through the plate and into the bone. Thus, a minimum of two clamps are currently typically used to perform fracture reduction, clamping of a plate to the reduced bone and securing of a drill guide in a desired location to guide a drill while drilling through the plate and into the bone.
This invention serves as both an external plate to bone clamp and reduction device for use with fractures of the hands and feet. The proximal portion of the device contains a bone hook, which can be adapted to fit around different bone diameters. The distal section of the device contains a thumbscrew assembly, which moves the reduction device and plate fixation pin away from and towards the fracture. Additionally, the medial section of the device contains a removable dial-able drill guide and a single hand operation handle. This disclosure is for a plate to bone clamp which also serves as a reduction device and drill guide.
The thumbscrew assembly of this device allows the surgeon to quickly reduce a fracture and temporarily clamp a plate in the desired location for attachment to the bone while holes are drilled through the plate into the bone at the desired locations. A removable drill guide is provided that allows a surgeon to visualize the placement of the drill and precisely control the orientation of the drill during the drilling operation. Thus, the disclosed device advantageously saves operating room time and allows for more accurate and less cumbersome procedure for repair of fractures of small bones.
According to one aspect of the disclosure, a surgical instrument for repairing a fracture in a small bone comprises a body portion, a first and second bone-engaging member, and a plate fixation member. The body portion is configured to facilitate manipulation of the surgical instrument. The first bone-engaging member is coupled to the body and configured to engage a first side of the small bone having a fracture therein at a first location. The second bone-engaging member is coupled to the body and configured to engage upon movement relative to the first bone-engaging member the small bone having the fracture in a position relative to the first location to facilitate in cooperation with the first bone-engaging member reduction of the fracture in the small bone. The plate fixation member is coupled to the body for movement relative to the body from a first position in which a plate can be inserted between the plate fixation member and the small bone and a second position in which a plate inserted between the plate fixation member and the small bone is temporarily fixed to the small bone.
According to a second aspect of the disclosure, a method of repairing a fracture in a fractured small bone is disclosed. According to the method a single instrument configured to capture a fractured small bone between a first member and a second member configured to move longitudinally with respect to each other and configured to engage a plate and seat the plate against the fractured small bone upon longitudinal movement of a third member with respect to the second member is provided. The first member of the instrument is disposed on a first side of the fractured small bone. The second member is disposed on a different side of the small bone. The fracture in the small bone is reduced by moving the first member relative to the second member to capture the fractured small bone between the first and second members. A plate is placed in engagement with the fractured small bone. The plate is seated against the fractured small bone by moving the third member longitudinally relative to the second member to bring the third member into engagement with the plate.
The above-noted features and advantages of the present invention, as well as additional features and advantages, will be readily apparent to those skilled in the art upon reference to the following detailed description and the accompanying drawings, which include a disclosure of the best mode of making and using the invention presently contemplated.
Corresponding reference characters indicate corresponding parts throughout the several views. Like reference characters tend to indicate like parts throughout the several views.